Cholesterol embolization is one of the serious complications of ulcerative
atheromatous plaque. Ischemic changes in the lower extremity, brain and other organs
including the kidney, pancreas and gastrointestinal tract due to atherosclerotic
microemboli have been well documented in autopsy cases in the western world. However,
it has been seldom reported in the Korean literature. We report a case of cholesterol
embolization of a foot that happened during coronary angiography with resultant
gangrene necessitating amputation.
A 60-year-old man visited hospital for the evaluation of angina pectoris. He felt a
sudden severe abdominal pain during the coronary angiography followed by loss of pulsation
of the dorsalis pedis arteries. Acute renal failure, glucose intolerance and
gangrene in both feet developed almost simultaneously, and Syme operation was done.
Dissection of the dorsalis pedis artery demonstrated segmental occlusion by cholesterol
emboli with various stages of organization.